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Gudlavalleti AG, Babu GR, Agiwal V, Murthy GVS, Schaper NC, van Schayck OCP. Undesirable Levels of Practice Behaviours and Associated Knowledge amongst Community Health Workers in Rural South India Responsible for Type 2 Diabetes Screening and Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:562. [PMID: 38791775 PMCID: PMC11121515 DOI: 10.3390/ijerph21050562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/06/2024] [Accepted: 04/15/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Type 2 diabetes (T2DM) poses an enormous global health care challenge, especially among rural communities. Healthcare in these areas can be inadequate and inaccessible due to socio-demographic barriers. To overcome this situation, many low- and middle-income countries are resorting to task shifting, using community health workers (CHWs) for diabetes management. However, its successful implementation depends on the practice behaviours and knowledge of these workers. OBJECTIVE This cross-sectional study aimed to evaluate the proficiency of CHWs involved in diabetes screening and management in rural South India by identifying the existing practice behaviours and knowledge gaps. METHODS Employing a customised questionnaire, developed through inputs from experts and government officials, we assessed practice behaviours and the corresponding knowledge base of 275 CHWs. Analytical methodologies consisted of descriptive statistics, logistic regression, and mosaic plots for comprehensive data interpretation. RESULTS The study showcased significant deficiencies in both practice behaviours (97%) and knowledge (95%) with current mean levels ranging from 48 to 50%, respectively, among the participants. The identified areas of insufficiency were broadly representative of the core competencies required for effective diabetes management, encompassing diabetes diagnosis and referral, HbA1c testing, diabetes diet, diabetes type and self-management, microvascular complications and their screening, peripheral neuropathy management, and diabetes risk assessment. In several areas, correct practice behaviour was reported by a relatively large number of CHWs despite incorrect answers to the related knowledge questions such as referral to the health centres, self-management, and calculation of diabetes risk assessment. CONCLUSION This study highlights widespread deficiencies (97% CHWs) in diabetes management practices and knowledge (95% CHWs). To overcome these deficiencies, a thorough needs assessments is vital for effective CHW training. Training of CHWs should not only identify prior knowledge and/or behaviour but also their interrelationship to help create a robust and flexible set of practice behaviours.
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Affiliation(s)
- Anirudh G. Gudlavalleti
- Pragyaan Sustainable Health Outcomes Foundation, World Trade Centre, Nanakramguda, Hyderabad 500032, Telangana, India;
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (N.C.S.); (O.C.P.v.S.)
| | - Giridhara R. Babu
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar;
| | - Varun Agiwal
- Indian Institute of Public Health Hyderabad, Rajendranagar, Hyderabad 500030, Telangana, India;
| | - G. V. S. Murthy
- Pragyaan Sustainable Health Outcomes Foundation, World Trade Centre, Nanakramguda, Hyderabad 500032, Telangana, India;
| | - Nicolaas C. Schaper
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (N.C.S.); (O.C.P.v.S.)
| | - Onno C. P. van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (N.C.S.); (O.C.P.v.S.)
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Khan J, Shaw S. Risk of cataract and glaucoma among older persons with diabetes in India: a cross-sectional study based on LASI, Wave-1. Sci Rep 2023; 13:11973. [PMID: 37488196 PMCID: PMC10366202 DOI: 10.1038/s41598-023-38229-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 07/05/2023] [Indexed: 07/26/2023] Open
Abstract
According to the International Diabetes Federation-2019 estimates, India is home to 77 million diabetic individuals which is projected to grow up to 147.2 million by 2045. Diabetes being a progressive health disorder leads to multiple morbidities and complications including eye diseases and visual impairments. As the burden of diabetes mellitus is increasing, eye problems like cataracts and glaucoma are commonly cited problems among the older adults. In this context, this study aims to provide the public health evidences on diabetes associated burden and risk of developing cataracts and glaucoma among older adults aged 60 and above in India. The analytical sample of this cross-sectional study comprised of 31,464 individuals aged 60 and above. Bivariate cross-tabulation and chi-square test were performed to understand the differential in the prevalence of cataracts and glaucoma by diabetes mellitus including the socio-economic and demographic characteristics of the individuals. Binary logistic regression estimation was executed to estimate the adjusted odds ratio for each of the outcome variables within a multivariate framework. The cataract problem affects more than one-fifth of the older people, while glaucoma affects 2% of them. The prevalence of cataract and glaucoma is 29% among diabetic older adults compared to 22% among non-diabetic persons. In terms of gender, the cataract prevalence is comparatively higher among females (25%) than males (21%). It is important to note that while adjusting for socio-economic and demographic characteristics, the likelihood of cataract (AOR 1.495; p-value < 0.01) and glaucoma (AOR 1.554; p-value < 0.01) is significantly higher among older adults with diabetes than among their counterparts. Medical practitioners should conduct prognosis for diabetic eye problems among patients and raise awareness about the potential risks of developing vision loss, such as cataracts and glaucoma, which are more prevalent among individuals with diabetes.
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Affiliation(s)
- Junaid Khan
- Department of Population and Development, International Institute for Population Sciences, Mumbai, India
| | - Subhojit Shaw
- Department of Population and Development, International Institute for Population Sciences, Mumbai, India.
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Kumar S, Mohanraj R, Raman R, Kumar G, Luvies S, Machhi SS, Chakrabarty S, Surya J, Ramakrishnan R, Conroy D, Sivaprasad S. 'I don`t need an eye check-up'. A qualitative study using a behavioural model to understand treatment-seeking behaviour of patients with sight threatening diabetic retinopathy (STDR) in India. PLoS One 2023; 18:e0270562. [PMID: 37319187 PMCID: PMC10270603 DOI: 10.1371/journal.pone.0270562] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 05/30/2023] [Indexed: 06/17/2023] Open
Abstract
Diabetic Retinopathy (DR) affects about 27% of patients with diabetes globally. According to the World Health Organization (WHO), DR is responsible for37 million cases of blindness worldwide. The SMART India study (October 2020-August 2021) documented the prevalence of diabetes, and DR in people40 years and above across ten Indian states and one Union Territory by conducting community screening. About 90% of people with sight threatening diabetic retinopathy (STDR) were referred from this screening study to eye hospitals for management, but failed to attend. This qualitative study, a component of the SMART India study, explored perceptions of referred patients regarding their susceptibility to eye related problems in diabetes and the benefits/barriers to seeking care. Perceived barriers from the viewpoint of ophthalmologists were also explored. Guided by the Health Beliefs Model (HBM), 20 semi structured interviews were carried out with consenting patients diagnosed with STDR. They included nine patients who had sought care recruited from eight eye hospitals across different states in India and eleven patients who did not seek care. Eleven ophthalmologists also participated. Four themes of analysis based on the HBM were, understanding of DR and its treatment, perceptions about susceptibility and severity, perceived barriers, perceived benefits and cues to action. Findings revealed poor understanding of the effects of diabetes on the eye contributing to low risk perception. Prohibitive costs of treatment, difficulties in accessing care services and poor social support were major barriers to seeking care. Ophthalmologists acknowledged that the absence of symptoms and the slow progressive nature of the disease deluded patients into thinking that they were fine. The study attests to the need for greater health literacy around diabetes, DR and STDR; for making treatment more affordable and accessible and for the development of effective patient education and communication strategies towards increasing compliance.
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Affiliation(s)
- Shuba Kumar
- Social Science Department, Samarth, Chennai, Tamil Nadu, India
| | - Rani Mohanraj
- Social Science Department, Samarth, Chennai, Tamil Nadu, India
| | - Rajiv Raman
- Department of Ophthalmology, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Geetha Kumar
- Department of Ophthalmology, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Sanjay Luvies
- Department of Ophthalmology, Giridhar Eye Institute, Cochin, Kerala, India
| | - Shivani Sunil Machhi
- Department of Ophthalmology, Aditya Jyot Foundation for Twinkling Little Eyes, Mumbai, Maharashtra, India
| | | | - Janani Surya
- Department of Ophthalmology, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Radha Ramakrishnan
- Department of Ophthalmology-NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Dolores Conroy
- Department of Ophthalmology-NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Sobha Sivaprasad
- Department of Ophthalmology-NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
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Pourhabibi N, Sadeghi R, Mohebbi B, Shakibazadeh E, Sanjari M, Tol A, Yaseri M. Factors affecting nonadherence to treatment among type 2 diabetic patients with limited health literacy: Perspectives of patients, their families, and healthcare providers. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:388. [PMID: 36618458 PMCID: PMC9818700 DOI: 10.4103/jehp.jehp_804_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 08/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Treatment adherence is one of the behaviors associated with type 2 diabetes that predicts whether it will be successfully treated or develop complications and become uncontrolled. This study aimed to determine factors affecting nonadherence to treatment among diabetic patients with limited health literacy from the perspectives of patients, their families, and healthcare providers. MATERIALS AND METHODS This qualitative study with a content analysis approach was conducted on 84 eligible type 2 diabetes patients with limited health literacy and poor adherence to treatment, as well as their families and healthcare providers using a purposive sampling method, in Kerman city in 2021. Interviews were conducted using a semistructured interview guide with a broad, open-ended question to provide a general history of the disease separately. The interviewer asked participants to identify the perceived barriers to treatment nonadherence. Each interview lasted 45-60 min. MAXQDA version 20 and inductive content analysis were used to code and analyze extracted data. RESULTS Four major themes emerged from the patients' perspectives as "financial problems," "individual factors," "problems related to medication availability," and "healthcare providers' poor practices." Two major themes were classified from the perspective of patients' families as "financial problems" and "Individual factors," and four major themes were identified from the viewpoint of healthcare providers including "financial problems," "individual factors," "scarcity and medication availability," and "poor practice of the healthcare provider." These mentioned barriers were confirmed regarding treatment nonadherence among study participants. CONCLUSION Study findings revealed different factors of treatment nonadherence among diabetic patients with limited health literacy. Therefore, these factors should be considered in tailoring promotive educational and supportive interventions. Considering the importance of adherence to treatment patients, planning empowerment family-based interventions focusing on health literacy improvement seems necessary.
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Affiliation(s)
- Nasrin Pourhabibi
- Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Mohebbi
- Department of Cardiology, Cardiovascular Intervention Research Center, Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojgan Sanjari
- Department of Internal Medicine, School of Medicine Endocrinology and Metabolism Research Center Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Azar Tol
- Department of Health Education and Health Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Das T, Takkar B, Sivaprasad S, Thanksphon T, Taylor H, Wiedemann P, Nemeth J, Nayar PD, Rani PK, Khandekar R. Recently updated global diabetic retinopathy screening guidelines: commonalities, differences, and future possibilities. Eye (Lond) 2021; 35:2685-2698. [PMID: 33976399 PMCID: PMC8452707 DOI: 10.1038/s41433-021-01572-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/28/2021] [Accepted: 04/21/2021] [Indexed: 02/04/2023] Open
Abstract
Diabetic retinopathy (DR) is a global health burden. Screening for sight-threatening DR (STDR) is the first cost-effective step to decrease this burden. We analyzed the similarities and variations between the recent country-specific and the International Council of Ophthalmology (ICO) DR guideline to identify gaps and suggest possible solutions for future universal screening. We selected six representative national DR guidelines, one from each World Health Organization region, including Canada (North America), England (Europe), India (South- East Asia), Kenya (Africa), New Zealand (Western Pacific), and American Academy of Ophthalmology Preferred Practice Pattern (used in Latin America and East Mediterranean). We weighed the newer camera and artificial intelligence (AI) technology against the traditional screening methodologies. All guidelines agree that screening for DR and STDR in people with diabetes is currently led by an ophthalmologist; few engage non-ophthalmologists. Significant variations exist in the screening location and referral timelines. Screening with digital fundus photography has largely replaced traditional slit-lamp examination and ophthalmoscopy. The use of mydriatic digital 2-or 4-field fundus photography is the current norm; there is increasing interest in using non-mydriatic fundus cameras. The use of automated DR grading and tele-screening is currently sparse. Country-specific guidelines are necessary to align with national priorities and human resources. International guidelines such as the ICO DR guidelines remain useful in countries where no guidelines exist. Validation studies on AI and tele-screening call for urgent policy decisions to integrate DR screening into universal health coverage to reduce this global public health burden.
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Affiliation(s)
- Taraprasad Das
- Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Hyderabad, India.
- Regional Chair, International Agency for the Prevention of Blindness, South East Asia, Hyderabad, India.
| | - Brijesh Takkar
- Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Hyderabad, India
| | - Sobha Sivaprasad
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- UCL Institute of Ophthalmology, London, UK
| | - Thamarangsi Thanksphon
- Former Director, Healthier Populations and Non-Communicable Disease, WHO Regional Office for South- East Asia Region, New Delhi, India
| | - Hugh Taylor
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Peter Wiedemann
- Department of Ophthalmology, University Leipzig, Leipzig, Germany
| | - Janos Nemeth
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Regional Chair, International Agency for the Prevention of Blindness, Europe, Budapest, Hungary
| | - Patanjali D Nayar
- Regional Advisor, Disability & Injury Prevention and Rehabilitation, Healthier Populations and Non-Communicable Disease, WHO Regional Office for South- East Asia Region, New Delhi, India
| | - Padmaja Kumari Rani
- Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Hyderabad, India
| | - Rajiv Khandekar
- Department of Research, Ophthalmic epidemiology & Low Vision, King Khalid Eye Hospital, Riyadh, Kingdom of Saudi Arabia
- British Columbia Centre for Epidemiologic & International Ophthalmology, University of British Columbia, Vancouver, BC, Canada
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Kumar A, Agarwal D, Kumar A. Diabetic retinopathy screening and management in India: Challenges and possible solutions. Indian J Ophthalmol 2021; 69:479-481. [PMID: 33595458 PMCID: PMC7942083 DOI: 10.4103/ijo.ijo_2357_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Atul Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Divya Agarwal
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Aman Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Das T, Behera UC, Bhattacharjee H, Gilbert C, Murthy GVS, Rajalakshmi R, Pant HB, Shukla R. Spectrum of eye disorders in diabetes (SPEED) in India: Eye care facility based study. Report # 1. Eye disorders in people with type 2 diabetes mellitus. Indian J Ophthalmol 2020; 68:S16-S20. [PMID: 31937723 PMCID: PMC7001179 DOI: 10.4103/ijo.ijo_33_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Purpose To document the spectrum of eye diseases in people with type 2 diabetes mellitus (T2DM) reporting to large eye care facilities in India. Methods The selection of eye care facilities was based on the zone of the country and robustness of the programs. Only people with known T2DM certified by internist, or taking antidiabetes medications, or referred for diabetes related eye diseases were recruited. The analysis included the demographic characteristics, systemic associations, ocular comorbidities, and visual status. Results People (11,182) with T2DM were recruited in 14 eye care facilities (3 in north, 2 in south central, 4 in south, 2 in west, and 3 in east zone); two were government and 12 were non-government facilities. Hypertension was the commonest systemic association (n = 5500; 49.2%). Diabetic retinopathy (n = 3611; 32.3%) and lens opacities (n = 6407; 57.3%) were the common ocular disorders. One-fifth of eyes (n = 2077; 20.4%) were pseudophakic; 547 (5.4%) eyes had glaucoma and 277 (2.5%) eyes had retinal vascular occlusion. At presentation, 4.5% (n = 502) were blind (visual acuity < 3/60 in the better eye) and 9.6% (n = 1077) had moderate to severe visual impairment (visual acuity <6/18-->3/60 in the better eye). Conclusion People with T2DM presenting at eye clinics in India have high rates of diabetic retinopathy and vision loss. Cataract is a very common occurrence. Advocacy, infrastructure strengthening, and human resource development are the key to address the growing threats of T2DM and eye care in India.
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Affiliation(s)
- Taraprasad Das
- Srimati Kanuri Santamma Centre for Vitreoretinal diseases, L V Prasad Eye Institute, Hyderabad, India
| | - Umesh C Behera
- Department of Retina and Vitreous, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
| | | | - Clare Gilbert
- London School of Hygiene and Tropical Medicine, London, UK
| | - G V S Murthy
- Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, India
| | - Ramachandran Rajalakshmi
- Department of Ophthalmology, Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Hira B Pant
- Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, India
| | - Rajan Shukla
- Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, India
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Murthy GVS, Gilbert C, Shukla R, Bala V, Anirudh GG, Mukpalkar S, Yamarthi P, Pendyala S, Puppala A, Supriya E, Batchu T. Overview and project highlights of an initiative to integrate diabetic retinopathy screening and management in the public health system in India. Indian J Ophthalmol 2020; 68:S12-S15. [PMID: 31937722 PMCID: PMC7001184 DOI: 10.4103/ijo.ijo_1964_19] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Purpose: Diabetes is a public health concern in India and diabetic retinopathy (DR) is an emerging cause of visual impairment and blindness. Approximately 3.35–4.55 million people with diabetes mellitus (PwDM) are at risk of vision-threatening DR (VTDR) in India. More than 2/3 of India's population resides in rural areas where penetration of modern medicine is mostly limited to the government public health system. Despite the increasing magnitude, there is no systematic screening for the complications of diabetes, including DR in the public health system. Therefore, a pilot project was initiated with the major objectives of management of DR at all levels of the government health system, initiating a comprehensive program for the detection of eye complications among PwDM at public health noncommunicable disease (NCD) clinics, augmenting the capacity of physicians, ophthalmologists and health support personnel and empowering carers/PwDM to control the risk of DR through increased awareness and self-management. Methods: A national task force (NTF) was constituted to oversee policy formulation and provide strategic direction. 10 districts were identified for implementation across 10 states. Protocols were developed to help implement training and service delivery. Results: Overall, 66,455 PwDM were screened and DR was detected in 16.2% (10,765) while VTDR was detected in 7.5%. 10.1% of those initially screened returned for the next annual assessment. There was a 7-fold increase in the number of PwDM screened and a 7.6-fold increase in the number of PwDM treated between 2016 and 2018. Conclusion: Services for detecting and managing DR can be successfully integrated into the existing public health system.
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Affiliation(s)
- G V S Murthy
- International Centre for Eye Health, Clinical Research Department, London School for Hygiene and Tropical Medicine, London, UK; Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India
| | - Clare Gilbert
- International Centre for Eye Health, Clinical Research Department, London School for Hygiene and Tropical Medicine, London, UK
| | - Rajan Shukla
- Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India
| | - Vidyadhar Bala
- Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India
| | - Gaurang G Anirudh
- Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India
| | - Sridivya Mukpalkar
- Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India
| | - Pavani Yamarthi
- Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India
| | - Suneetha Pendyala
- Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India
| | - Anusha Puppala
- Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India
| | - Edla Supriya
- Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India
| | - Tripura Batchu
- Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, Telangana, India
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- India DR Program Implementation
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Kumar S, Kumar G, Velu S, Pardhan S, Sivaprasad S, Ruamviboonsuk P, Raman R. Patient and provider perspectives on barriers to screening for diabetic retinopathy: an exploratory study from southern India. BMJ Open 2020; 10:e037277. [PMID: 33303431 PMCID: PMC7733174 DOI: 10.1136/bmjopen-2020-037277] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Diabetic retinopathy is one of the leading causes of visual impairment after cataract and uncorrected refractive error. It has major public health implications globally, especially in countries such as India where the prevalence of diabetes is high. With timely screening and intervention, the disease progression to blindness can be prevented, but several barriers exist. As compliance to diabetic retinopathy screening in people with diabetes is very poor in India, this study was conducted to explore understanding of and barriers to diabetic retinopathy screening from the perspectives of patients and healthcare providers. METHODS Using qualitative methods, 15 consenting adult patients with diabetes were selected purposively from those attending a large tertiary care private eye hospital in southern India. Eight semistructured interviews were carried out with healthcare providers working in large private hospitals. All interviews were audiotaped, transcribed verbatim and analysed using the framework analytical approach. RESULTS Four themes that best explained the data were recognising and living with diabetes, care-seeking practices, awareness about diabetic retinopathy and barriers to diabetic retinopathy screening. Findings showed that patients were aware of diabetes but understanding of diabetic retinopathy and its complications was poor. Absence of symptoms, difficulties in doctor-patient interactions and tedious nature of follow-up care were some major deterrents to care seeking reported by patients. Difficulties in communicating information about diabetic retinopathy to less literate patients, heavy work pressure and silent progression of the disease were major barriers to patients coming for follow-up care as reported by healthcare providers. CONCLUSIONS Enhancing patient understanding through friendly doctor-patient interactions will promote trust in the doctor. The use of an integrated treatment approach including education by counsellors, setting up of patient support groups, telescreening approaches and use of conversation maps may prove more effective in the long run.
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Affiliation(s)
| | - Geetha Kumar
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India
| | - Saranya Velu
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India
| | - Shahina Pardhan
- Vision and Eye Research Unit (VERU), School of Medicine, Anglia Ruskin University, Cambridge, UK
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | | | - Rajiv Raman
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India
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Ngah NF, Muhamad NA, Asnir ZZ, Abdul Aziz RA, Mhad Kassim Z, Sahar SA, Ahmad Tarmidzi NA, Chan LY, Uthman R, Satar N, Husain NZ, Adnan A, Kayalakakathu JM, Kadas B, Mohamad NS, Kassim SA. Descriptive assessment on diabetic retinopathy screening in an awareness programme in Malaysia. Int J Ophthalmol 2020; 13:1808-1813. [PMID: 33215014 DOI: 10.18240/ijo.2020.11.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 05/13/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To determine the prevalence of diabetic retinopathy (DR) among diabetic patients at the primary health clinics in Selangor, Malaysia. METHODS All diabetic patients were screened in Retinal Disease Awareness Programme (RDAP) and those who had significant DR changes were referred to the hospital for further management. Descriptive analyses were done to determine the prevalence of DR and sociodemographic characteristics among patients with diabetic. Univariate and multivariable analysis using Logistic regression were performed to find association and predictor factors in this screening. RESULTS A total of 3305 patients aged 40y and above were screened for DR. Of the patients screened, 9% patients were found to have DR and other visual complication such as maculopathy (0.9%), cataract (4.8%) and glaucoma (0.4%). The mean age of patients without retinopathy was 57.82±8.470y and the mean age of patients with DR was 63.93±9.857y. About 61.5% of the patients screened were aged below 60y and 38.5% were aged 60y and above. Majority of the patients screened were women 58.5% and Malay in the age group of 50-59y, while 27% were aged 60-69y. Significant association were found between age, sex, race, visual loss and DR. CONCLUSION Although the prevalence of DR among patients is not alarming, effective interventions need to be implemented soon to avert a large burden of visual loss from DR.
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Affiliation(s)
- Nor Fariza Ngah
- Department of Ophthalmology, Shah Alam Hospital, Selangor 40000, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence Based Healthcare, National Institutes of Health, Ministry of Health, Selangor 40170, Malaysia.,Institute for Public Health, National Institutes of Health, Ministry of Health, Selangor 40170, Malaysia
| | | | | | | | - Siti Aishah Sahar
- Department of Ophthalmology, Putrajaya Hospital, Federal Territory 62250, Malaysia
| | | | - Li Yen Chan
- Department of Ophthalmology, Tengku Ampuan Rahimah Hospital, Selangor 41200, Malaysia
| | - Rosmawati Uthman
- Department of Ophthalmology, Selayang Hospital, Selangor 68100, Malaysia
| | - Narjis Satar
- Department of Ophthalmology, Sungai Buloh Hospital, Selangor 47000, Malaysia
| | - Noor Zahirah Husain
- Department of Ophthalmology, Kuala Lumpur Hospital, Federal Territory 50586, Malaysia
| | - Azian Adnan
- Department of Ophthalmology, Selayang Hospital, Selangor 68100, Malaysia
| | | | - Bariyah Kadas
- Selangor State Health Department, Ministry of Health, Selangor 40100, Malaysia
| | - Noor Suriani Mohamad
- Department of Ophthalmology, Tengku Ampuan Rahimah Hospital, Selangor 41200, Malaysia
| | - Shaiful Azlan Kassim
- Institute for Public Health, National Institutes of Health, Ministry of Health, Selangor 40170, Malaysia
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11
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Yaddanapalli SC, Srinivas R, Simha BV, Devaki T, Viswanath V, Pachava S, Chandu VC. Utilization of health services in Tenali Mandal, Andhra Pradesh- A cross-sectional study. J Family Med Prim Care 2019; 8:2997-3004. [PMID: 31681681 PMCID: PMC6820388 DOI: 10.4103/jfmpc.jfmpc_462_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 06/19/2019] [Accepted: 08/01/2019] [Indexed: 11/04/2022] Open
Abstract
Introduction India has a plurality of health care with different systems of medicine delivered by government and local bodies in hospitals and clinics. Public hospitals provide 60% of all hospitalizations, while the private sector provides 75% of all routine care. Utilization is the actual attendance by the members of the public at health care facilities, which measures the number of visits per year or the number of people with at least one visit during the previous year, serves as an important tool and acts as a guiding path in understanding disease profile and also helps resource allocation. Materials and Methods A cross-sectional study was done using the National Pathfinder survey (stratified cluster random sampling) to know the health care utilization, profile, and pattern in Tenali Mandal, Guntur, Andhra Pradesh. Results The study sample comprised of 1,500 subjects who were equally divided among 5 age groups. Out of 1,500 participants, 52.8% were females and 47.2% were males. In total, 71.7% of the study participants have utilized health services, with majority of them (44.5%) had availed services within the last 6 months with prime reason of fevers (15.8%), while the main barrier for not seeking care was distance (17.03%), almost an equal proportion of the population sought care for their problems through home remedies and over-the-counter. Conclusion There is an utmost need to minimize barriers of utilizing by making them aware of the health problems, so that they develop a positive attitude toward health care utilization. Therefore, knowledge of utilization of health services and associated factors is important in planning and delivery of interventions by the primary care physicians to improve health services coverage.
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Affiliation(s)
- Suresh Chand Yaddanapalli
- Department of Public Health Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Ravuri Srinivas
- Department of Public Health Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - B Vikram Simha
- Department of Public Health Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Talluri Devaki
- Department of Public Health Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - V Viswanath
- Department of Public Health Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Srinivas Pachava
- Department of Public Health Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Viswa Chaitanya Chandu
- Department of Public Health Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
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12
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Lawrenson JG, Graham-Rowe E, Lorencatto F, Rice S, Bunce C, Francis JJ, Burr JM, Aluko P, Vale L, Peto T, Presseau J, Ivers NM, Grimshaw JM. What works to increase attendance for diabetic retinopathy screening? An evidence synthesis and economic analysis. Health Technol Assess 2019; 22:1-160. [PMID: 29855423 DOI: 10.3310/hta22290] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Diabetic retinopathy screening (DRS) is effective but uptake is suboptimal. OBJECTIVES To determine the effectiveness of quality improvement (QI) interventions for DRS attendance; describe the interventions in terms of QI components and behaviour change techniques (BCTs); identify theoretical determinants of attendance; investigate coherence between BCTs identified in interventions and determinants of attendance; and determine the cost-effectiveness of QI components and BCTs for improving DRS. DATA SOURCES AND REVIEW METHODS Phase 1 - systematic review of randomised controlled trials (RCTs) evaluating interventions to increase DRS attendance (The Cochrane Library, MEDLINE, EMBASE and trials registers to February 2017) and coding intervention content to classify QI components and BCTs. Phase 2 - review of studies reporting factors influencing attendance, coded to theoretical domains (MEDLINE, EMBASE, PsycINFO and sources of grey literature to March 2016). Phase 3 - mapping BCTs (phase 1) to theoretical domains (phase 2) and an economic evaluation to determine the cost-effectiveness of BCTs or QI components. RESULTS Phase 1 - 7277 studies were screened, of which 66 RCTs were included in the review. Interventions were multifaceted and targeted patients, health-care professionals (HCPs) or health-care systems. Overall, interventions increased DRS attendance by 12% [risk difference (RD) 0.12, 95% confidence interval (CI) 0.10 to 0.14] compared with usual care, with substantial heterogeneity in effect size. Both DRS-targeted and general QI interventions were effective, particularly when baseline attendance levels were low. All commonly used QI components and BCTs were associated with significant improvements, particularly in those with poor attendance. Higher effect estimates were observed in subgroup analyses for the BCTs of 'goal setting (outcome, i.e. consequences)' (RD 0.26, 95% CI 0.16 to 0.36) and 'feedback on outcomes (consequences) of behaviour' (RD 0.22, 95% CI 0.15 to 0.29) in interventions targeting patients and of 'restructuring the social environment' (RD 0.19, 95% CI 0.12 to 0.26) and 'credible source' (RD 0.16, 95% CI 0.08 to 0.24) in interventions targeting HCPs. Phase 2 - 3457 studies were screened, of which 65 non-randomised studies were included in the review. The following theoretical domains were likely to influence attendance: 'environmental context and resources', 'social influences', 'knowledge', 'memory, attention and decision processes', 'beliefs about consequences' and 'emotions'. Phase 3 - mapping identified that interventions included BCTs targeting important barriers to/enablers of DRS attendance. However, BCTs targeting emotional factors around DRS were under-represented. QI components were unlikely to be cost-effective whereas BCTs with a high probability (≥ 0.975) of being cost-effective at a societal willingness-to-pay threshold of £20,000 per QALY included 'goal-setting (outcome)', 'feedback on outcomes of behaviour', 'social support' and 'information about health consequences'. Cost-effectiveness increased when DRS attendance was lower and with longer screening intervals. LIMITATIONS Quality improvement/BCT coding was dependent on descriptions of intervention content in primary sources; methods for the identification of coherence of BCTs require improvement. CONCLUSIONS Randomised controlled trial evidence indicates that QI interventions incorporating specific BCT components are associated with meaningful improvements in DRS attendance compared with usual care. Interventions generally used appropriate BCTs that target important barriers to screening attendance, with a high probability of being cost-effective. Research is needed to optimise BCTs or BCT combinations that seek to improve DRS attendance at an acceptable cost. BCTs targeting emotional factors represent a missed opportunity to improve attendance and should be tested in future studies. STUDY REGISTRATION This study is registered as PROSPERO CRD42016044157 and PROSPERO CRD42016032990. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- John G Lawrenson
- Centre for Applied Vision Research, School of Health Sciences, City, University of London,London,UK
| | - Ella Graham-Rowe
- Centre for Health Services Research, School of Health Sciences, City, University of London,London,UK
| | - Fabiana Lorencatto
- Centre for Health Services Research, School of Health Sciences, City, University of London,London,UK
| | - Stephen Rice
- Health Economics Group, Institute of Health and Society, Newcastle University,Newcastle upon Tyne,UK
| | - Catey Bunce
- Department of Primary Care & Public Health Sciences, King's College London,London,UK
| | - Jill J Francis
- Centre for Health Services Research, School of Health Sciences, City, University of London,London,UK
| | | | - Patricia Aluko
- Health Economics Group, Institute of Health and Society, Newcastle University,Newcastle upon Tyne,UK
| | - Luke Vale
- Health Economics Group, Institute of Health and Society, Newcastle University,Newcastle upon Tyne,UK
| | - Tunde Peto
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast,Belfast,UK
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute,Ottawa, ON,Canada.,School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa,Ottawa, ON,Canada
| | - Noah M Ivers
- Department of Family and Community Medicine, Women's College Hospital - University of Toronto,Toronto, ON,Canada
| | - Jeremy M Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute,Ottawa, ON,Canada.,Department of Medicine, University of Ottawa,Ottawa, ON,Canada
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A study of eye care service utilization among diabetic patients visiting a tertiary care hospital in Coastal Karnataka, southern India. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-018-0617-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Gudlavalleti VS, Shukla R, Batchu T, Malladi BVS, Gilbert C. Public health system integration of avoidable blindness screening and management, India. Bull World Health Organ 2018; 96:705-715. [PMID: 30455518 PMCID: PMC6238995 DOI: 10.2471/blt.18.212167] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/22/2018] [Accepted: 06/26/2018] [Indexed: 01/08/2023] Open
Abstract
In India, 73 million people have diabetes and 3.5 million infants are born preterm. Without timely screening, there is a risk of visual loss due to diabetic retinopathy and retinopathy of prematurity in these two groups, respectively. Both conditions are emerging causes of visual impairment in India but there is no public health programme for screening or management. Pilot projects were initiated in 2014 to integrate the screening and management of these conditions into existing public health systems, particularly in rural communities and their referral networks. The World Health Organization's health systems framework was used to develop the projects and strategies were developed with all stakeholders, including the government. Both projects involved hub-and-spoke models of care units around medical schools. For diabetic retinopathy, screening was established at primary health-care facilities and treatment was provided at district hospitals. For retinopathy of prematurity, screening was integrated into sick newborn care units at the district level and treatment facilities were improved at the closest publically funded medical schools. In the first two years, there were substantial improvements in awareness, screening, treatment and partnership between stakeholders, and changes in public health policy. By March 2018, diabetic retinopathy screening was established at 50 facilities in 10 states and treatment had been improved at 10 hospitals, whereas retinopathy of prematurity screening was established at 16 sick newborn care units in district hospital in four states and treatment had been improved at six medical schools. Advocacy within state governments was critical to the success of the initiative.
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Affiliation(s)
- Venkata Sm Gudlavalleti
- Indian Institute of Public Health, Public Health Foundation of India, Kavuri Hills, Madhapur,
Hyderabad 500 033,Telangana, India
| | - Rajan Shukla
- Indian Institute of Public Health, Public Health Foundation of India, Kavuri Hills, Madhapur,
Hyderabad 500 033,Telangana, India
| | - Tripura Batchu
- Indian Institute of Public Health, Public Health Foundation of India, Kavuri Hills, Madhapur,
Hyderabad 500 033,Telangana, India
| | - Bala Vidyadhar S Malladi
- Indian Institute of Public Health, Public Health Foundation of India, Kavuri Hills, Madhapur,
Hyderabad 500 033,Telangana, India
| | - Clare Gilbert
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, England
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Rani PK, Nangia V, Murthy KR, Khanna RC, Das T. Community care for diabetic retinopathy and glaucoma in India: A panel discussion. Indian J Ophthalmol 2018; 66:916-920. [PMID: 29941730 PMCID: PMC6032761 DOI: 10.4103/ijo.ijo_910_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Diabetic retinopathy (DR) and glaucoma are emerging causes of blindness and visual impairment in India and the world. Both diseases do not have any early warning symptoms, and once the symptoms appear, the diseases are reasonably advanced. Because of the long-standing nature of the diseases, one cannot adopt the cataract detection and treatment model so successfully developed in India. It requires an altogether different approach for screening and related infrastructure including human capital development. The solutions developed to reduce the burden of DR/glaucoma should be customized to urban, semi-urban, and rural areas. Greater advocacy, improving the health-seeking behavior, development of infrastructure and skilled personnel appropriate for the points of care, and an emphasis in comprehensive eye care are some of the solutions.
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Affiliation(s)
- Padmaja Kumari Rani
- Smt.Kanuri Santhamma Retina Vitreous Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Vinay Nangia
- Department of Glaucoma, Suraj Eye Institute, Nagpur, India
| | - Krishna R Murthy
- Department of Retina and Vitreous, Vittala Eye Institute, Bangalore, India
| | - Rohit C Khanna
- Gullapalli Prathibha Rao International Center for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
| | - Taraprasad Das
- Smt.Kanuri Santhamma Retina Vitreous Centre, L V Prasad Eye Institute, Hyderabad, India
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Konstantinidis L, Carron T, de Ancos E, Chinet L, Hagon-Traub I, Zuercher E, Peytremann-Bridevaux I. Awareness and practices regarding eye diseases among patients with diabetes: a cross sectional analysis of the CoDiab-VD cohort. BMC Endocr Disord 2017; 17:56. [PMID: 28882117 PMCID: PMC5590154 DOI: 10.1186/s12902-017-0206-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 08/29/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The increasing prevalence of diabetes is leading to a rise of eye diseases, augmenting the risk of sight-threatening complications. The aim of this study was to evaluate prevalence, awareness and practices regarding eye diseases among patients with diabetes in the canton of Vaud, Switzerland. METHODS A cohort of 323 patients with diabetes completed a self-administered questionnaire assessing prevalence, awareness and practices regarding eye diseases, besides health status and quality of care measures. Descriptive analyses followed by exploratory subgroup analyses and linear regressions were performed to investigate factors associated with awareness and practices. RESULTS While diabetic retinopathy was reported by 40.9% of patients with type 1 diabetes and 9.8% of patients with type 2 diabetes, 35.8% and 12.6% of all participants reported cataract and glaucoma, respectively. Awareness that diabetes could damage the eyes was reported by almost all participants; the majority was also aware of the importance of glycemic control and regular eye examination in preventing eye diseases. In contrast, only 70.5% of participants underwent an eye examination by an ophthalmologist during the past year. Eye examination was associated with better patients' awareness. Barriers mentioned by patients revealed a lack of knowledge about screening guidelines, in particular regarding the preventive nature of eye examinations. CONCLUSIONS Despite high levels of awareness regarding diabetic eye diseases, a significant proportion of patients with diabetes did not report annual eye examination. Both healthcare strategic efforts targeting the promotion of regular eye examination and initiatives aiming at improving knowledge of screening guidelines should be encouraged. TRIAL REGISTRATION ClinicalTrials.gov on 9th July 2013, identifier NCT01902043 (retrospectively registered).
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Affiliation(s)
- Lazaros Konstantinidis
- Jules Gonin University Eye Hospital, University of Lausanne, Avenue de France 15 - Case Postale 5143 - 1000 Lausanne 2, Lausanne, Switzerland
| | - Tania Carron
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Léonie Chinet
- Public Health Service, Department of Health and Social Action, Canton of Vaud, Lausanne, Switzerland
| | - Isabelle Hagon-Traub
- Public Health Service, Department of Health and Social Action, Canton of Vaud, Lausanne, Switzerland
| | - Emilie Zuercher
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Isabelle Peytremann-Bridevaux
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Public Awareness regarding Common Eye Diseases among Saudi Adults in Riyadh City: A Quantitative Study. J Ophthalmol 2017; 2017:9080791. [PMID: 28751985 PMCID: PMC5511645 DOI: 10.1155/2017/9080791] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 06/05/2017] [Indexed: 11/25/2022] Open
Abstract
Aim The current study aimed to evaluate the knowledge of eye disease and awareness of eye care among the Saudi adults and to explore existing eye-related misconceptions in the community. Methods A cross-sectional study was conducted in Riyadh city during May and June 2016. A self-administered anonymous online questionnaire was used to explore the most common misconceptions related to eye diseases and eye care. Results Out of 1000 individuals, only 711 (71.1%) participant responses were received. The participants' acceptable knowledge (score ≥50%) was high about the eye problem in diabetes (88.6%), ocular trauma (81.2%), and other general eye diseases (91.3%), whereas low about refractive errors (63%), pediatric eye problems (51.5%), and glaucoma (14.8%). The variation in knowledge about specific ocular morbidities was significant (p < 0.001). The majority of participants reported sources of information about the common eye diseases and eye care encountered from the community, internet-based resources, and social media. Conclusions The majority of the participants had awareness about the common eye diseases, whereas low percentage of participant's awareness about specific condition of eye diseases. Public eye health awareness should be more focused on social media and the internet to be able to cover the younger individuals of the community.
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